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Creative Destruction in Clinical Laboratories

Two-part session to cover practice-changing technologies.

We are in a period of creative destruction in clinical laboratory medicine, with technological innovation and groundbreaking scientific findings coming at a galloping speed. The two-part program at the 68th AACC Annual Scientific Meeting & Clinical Lab Expo, Technologies That Could Change the Future of the Clinical Laboratory, helps put into context these rapidly evolving discoveries.

Speakers Carl Wittwer, MD, PhD, of the University of Utah, and J. Michael Ramsey, of the University of North Carolina at Chapel Hill, will take the stage in the first session to discuss very rapid molecular testing and miniaturized mass spectrometry devices. They will be followed in the second session by Timothy Amukele, PhD, MD, of Johns Hopkins University, discussing drone technology to transport laboratory samples, and James Nichols, PhD, of Vanderbilt University Medical Center, highlighting the promise of newer blood collection devices that require far less blood for sampling. CLN Stat asked the speakers why these technologies are revolutionary.

“Think Tricorder speed,” said Wittwer about the promise of rapid molecular testing. He will demonstrate real-time polymerase chain reaction in less than 30 seconds and high-speed melting analysis for identification and genotyping. The question he’ll explore: “How fast can sample acquisition, sample preparation, amplification, and analysis occur?” The answer is important, he said, because in some cases speed can mean the difference between life and death.

Ramsey and his team have been working for more than 20 years on miniaturized mass spectrometry instruments coupled to microfluidic separations devices. To date, they have demonstrated that mass spectrometry can be performed at pressures 103 to 1010 higher than those found in today’s commercial mass spectrometers. “This has allowed us to realize the world’s first handheld mass spectrometer,” he said, because vacuum requirements previously limited the size and weight of MS platforms.

Ramsey also plans to discuss another technology his lab developed: microfluidic-based capillary electrophoresis devices with integrated electrospray emitters. “These liquid phase separation devices provide higher separation efficiencies than liquid chromatography while separation times are typically less than five minutes,” he explained. With this technology, Ramsey’s team has identified amino acids, metabolites, and proteins using whole fresh blood, dried blood spots, urine, and cell lysates.

The drone technology Amukele will discuss could be invaluable in developing countries, he said. A proof-of-concept study completed last year found that the 40-minute drone flight does not affect the results of common and routine blood tests.

Nichols told CLN Stat the newer blood collection devices he’ll discuss could reduce the risk of hospital-acquired anemia from repeated laboratory blood collection by minimizing sample volumes, standardizing phlebotomy processing, and integrating testing with sample collection. Widespread adoption of the technology, he said, requires not just Food and Drug Administration approval, but also ease of use, technical performance of test results, cost-effectiveness, and the ability of these technologies to integrate with current laboratory instrumentation and processes.